HomeMy WebLinkAbout038-1106-60-200
oc ~ ~
a a o
~ I
°c I
N
n
~ I
tl
1
O
,4i
N
Z C
U. 0 EO
3
a ~ I ~
I
M H
3
y N ~ tD
Z y \l ~4
p J H N
~
Z r d U 4J p
cD m w a m a~ 3 Pa
N H Z cn DO 4{
p P4 O U
O Z a C
r 7
W M O
m
c7 N
N N 7 I ~
m m
d
U) 1 O
y C
•IV a = o W
o s
z°mz o
° C C L7 H
N ul
H IYO
o. U I H ~ ~
u~i a ~o : `
D O a` °a Q ~ Z
Q o ~Nmv~ ~Io a o
r rr
• r N~ O O a s z 0 ~ o
~a a 3°c 001 ate' w a~i
U) J U Z rn rn Z >
~V U N N N 'z ( U,,
a
m N C
9 ~ d ~ w
U a m Q> ~ m
p p N w
C C O) tll V!
r N C
[O N m p O E O
0) aUi c vd°o
st N y O N
O
40 ° C m p O p N
C r d p yr Z .O+ Op
a. p N
N R
• ,„~i O N fA J. O Z N S Fp- fn
CC I
O
v C~
t/~ o a
• cl CL ~ a
t`Iv E c c 50
t A c°~IL ',o n~
~ a '
Form- S T C - 104
AS BUILT SANITARY SYSTEM REPORT
Ci f. Ald,
OWNER TOWNSHIP ,he wzr'd SEC. _ T ~N-R_ LW
ADDRESS ST. CROIX COUNTY, WISCONSIN
y~,7
SUBDIVISION LOT LOT SIZE
PLAN VIEW
Distances and dimensions to meet requirements of I1HR 83
SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM
r-/EADF •~S - X06 -
sa'
y'
INDICATE N RTH ROW
BENCHMARK: Describe the vertical reference point used f
Elevation of vertical reference point: Proposed slope at site:
SEPTIC TANK: Manufacturer:-0 Liquid Capacity: h2W
Number of rings used: Tank manhole cover elevation:
Tank Inlet Elevation: Tank Outlet Elevation:
Number of feet from nearest Road: Front 10 SideA4V 671 Rear, O feet
r ~
From nearest property line Front 10 Side Rear, O feet 10 Number of feet from: well building
(Include this information of the above plot plan)( 2 reference dimensions to septic tank)
err Vr17VVCV CTnV
PUMP CHAMBER
" Manufacturer: Liquid Capacity:
Pump Model: Pump/Siphon Manufacturer: Pump Size
Elevation of inlet: Bottom of tank elevation:
Pump off switch elevation: Gallons per cycle:
Alarm Manufacturer: Alarm Switch Type:
Number of feet from nearest property line: Front, O Side, O Rear, 0 Ft.
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SOIL ABSORPTION SYSTEM
Bed: Trench
Width: ~ Lenith: Number of Lines:- Area Built:_
Fill depth to top of pipe: - Zlz
Number of feet from nearest property line: Front, O Side, (D Rear,0 Ft
Number of feet from well:
Number of feet from building:
(Include distances on plot plan).
SEEPAGE PIT
Size: Number of pits: Diameter:
Liquid depth: Bottom of seepage pit elevation:
Area Built:
Has either a drop box O or distribution box O been used on any of the above soil
absorbtion sytems? (Check one).
HOLDING TANK
Manufacturer: Capacity:
Number of rings used: Elevation of bottom of tank:
` Elevation of inlet:
Number of feet from nearest property line: Front, O Side, O Rear, 0Ft.
Number of feet from well:
Number of feet from building:
Number of feet from nearest road:
Alarm Manufacturer:
I
Inspector:
Dated: Plumber on job:
426ea JZ
License Number:
3/84:mj
EPARTMENT OF INDUSTRY, INSPECTION REPORT FOR - SAFETY & BUILDINGS
ABOR & HUMAN RELATIONS PRIVATE SEWAGE SYSTEMS DIVISION
:O. BOAC 7969 BUREAU OF PLUMBING
ADISON, WI 53707
MCONVENTIONAL ❑ALTERNATIVE State Plan I.D. Namltet
(11 nHpnMl
❑ Holding Tank D In-Ground Pressure ❑ Mound
NAME Of PERMIT HOLDER. ADDRESS OF PERMIT HOLDER. INSPECT( N DATE-
Gerald Larson R. R. , New Richmond, WI 54017 d -;'zr,?6
BENCH MARK (Permanent reference pomil DESCRIBE IF DIFFERENT FROM PLAN REF. PT. ELEV.: CST Fitt PT ELEV
NE SE, Section 26, T31N-R18W, Town of Star Prairie ir
me nl Plumber, MP/MPRSW No.. County- San+wy Pnmu Number.
Cal Powers, Jr. 1563 St. Croix 83841
EPTIC TANK/HOL G TANK:
MANUFACTURER LIQUID CAPACITY TANK INLET ELEV. TANK OUTLET ELEV WARNING LAB L LOCKING COVER
Q P RED PROVIDED
g S y~2 YES 1:1 NO ❑ YES NO
/ 70
BEDDING ENT DIA. IWNT MAIL. HIGH WATER NUMBER OF ROAD: PROPERTY Iwo BUILDING VENT TO FRESH
ALARM FEET FROM L NE Ain INLET
DYES DYES NEAREST Z OSING CHA BER:
MANIIF ACTUREH BEDDING LIQUID CAPACITY PUhill MODEL PUMP. SIPHON MANUF ACIUHFH WARN I NG LABEL LOCKING COVER
PROVIDED PROVIDED
DYES ONO OYES ONO DYES EINO
GALLONS PER CYCLE: PUMP AND CONTROLS OPERATIONAL NUMBER OF P141 If'[ 141Y WF Lk HIIIID1NIi VENT TOFRe Sft
(DIFFERENCE BETWEEN FEET FROM LINE AIR INt f T
PUMP ON AND OFF) DYES ONO NEAREST 10
rO IL ABSORPTION SYSTEM. Check the soil moisture at the depth of plowing II Nt; 11t DIAMI II II vAII It1AI AND ht A/IKINI.
excvaton, (If soil can be rolled into a wire, construction shall cease ntil FORCE
soil is dry enough to continue.) MAIN
NVENTIONALSYSTEM:
WIDTH LENGTH NO OF DI SIR PIPE SPACING COVER JINSIIIf IA a111ti I IOU11)
BED/TRENCH THE NCHFS I M1t /1~EH14L' PIT
DIMENSIONS I I S - J` DFI•I11
I,HAV L()V 1E FILL UEPTII UIST11 PIP( DISTN PIPE DISTR. PIPE MATERIAL NO Ul. H NUMBER OF PHOPE IIIV WELL HUILDING VENT III F HI :.U
TIF LOW PIP f ( ABOVE COVER ! I ffyV INI I 1 ELIV~1INDC, PIPES +LINF p AIN INLt II
3 15 d5 • ! Z 7 Z~ 7/ FEET FROM lj
NEAREST
l
OUND SYSTEM:
Mound site plowed perpendicular to slope Check the texture of the fill material for PROVIDE A DIAGRAM OF SYSTEM
and furrows thrown upslope: mound systems to make certain that it . ON REVERSE SIDE. SHOW ELEVA-
DYES UNO meets the criteria for medium sand. TIONS MEASURED.
OIL COVER TFx1-* PF HNIANI NI MAHR1 HS 1111SI IIVATIIN WI 11 S
_ DYES ❑NO OYES LINO
UfPO/OVER THENCH BEU DEPTFI OV f H THENC14 SET) V III OF TOPSOIL SOII ITH SFf I1fU MUI CIO 1)
CFNIEH DE
EDGES -
DYES ONO OYES ONO DYES NO
PRESSURIZED DISTRIBUTION SYSTEM:
WIDTH LENGT/f NO OF LATERAL SPACINIi 11HAVEL DE PTH HF LOW YIVI / I1 L UFPI11 AHOVf f.UVt H
BED/TRENCH TRENCHES
DIMENSIONS
MANIFOLD PIMP MANY OLD UISTR PIPE MANII OLD MATERIAL Nt) DISI11 1ASI11 PIP! 5i_%T111HIItIONPt1'I MATIHIAI &hLU1RIN1.
ELEVATION AND ELEV ELEV DIA ELEV. PIPES DIA
DISTRIBUTION
r FORMATION t1OLES"F HOLE SPACING Ul?lLl L U C0141if C I I Y COVFH MATERIAL VI 14 T HlM 111 I CONHE SVI)NDS III APP11UV1 I)
PLnNs
DYES ❑NO OYES EINO
COMMENTS: PERMANENT MARKER: OBSERVATIONWEL LS: NUMBER OF PROPERTY WELL BUILDING
FEET FROM LINE
DYES El NO DYES 1:1 NO NEAREST
Sketch System on fain in county file for audit.
Reverse Side.
SIGNATURE
DILHR SBD 6710 (R. 01/82)-`"
C
TY
SANITARY PERMIT APPLICATION
OU ~
DILHA In accord with ILHR 83.05, Wis. Adm. Code
STATE SANITARY PERMIT #
E -Attach complete plans (to the county copy only) for the system, on paper not less than 3 y
8% X 11 inches in size. STATE PLAN I.D. NUMBER
-See reverse side for instructions for completing this application.
1. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION. PETITION
FOR VARIANCE ❑ YES ❑ NO
PR)PE TY OWNER PROPERTY LOCATION
1/4
PRO E TY ER'S MAILING ADDRESS LOT NUMBER BLOCK NUMBER SUBDIVISION NAME
C TY, ST TE ZIP CODE PHONE NUMBER
❑ CITY VILLAGE NEAREST ROAD KE OR LANDMARK
p e
II. TYPE OF BUILDING OR USE SERVED: /C'_ Ate), Q 3 rS -t,/ ~ BOO ~
Number of Bedrooms if 1 or 2 Family OR ❑ Public (Specify):
111. PURPOSE OF APPLICATION: (Check only one in #1. Check # 2,3 or 4, if applicable)
1. a. ® New b. ❑ Replacement c. ❑ Replacement of d. ❑ Reconnection of e. ❑ Repair of an
System System Septic Tank Only an Existing System Existing System
2. ❑ A Sanitary Permit was previously issued. Permit # Date Issued
3. ❑ An Existing System has been inspected and soil conditions meet minimum requirements.
4. ❑ The System is shared by more than one owner/building. Attach Common Ownership Agreement to County Copy.
IV. TYPE OF SYSTEM: (Check only one in #1 and only one in #2)
1. a. Conventional b. ❑ Alternative c. ❑ Experimental
2. a. ❑ System- b. ❑ Holding c. ❑ Pit Privy d. ❑ Vault Privy e. ❑ Mound f. ❑ IGP
In-Fill Tank
V. ABSORPTION SYSTEM INFORMATION: (Check one)
1. a. Seepage Bed _b. E1 Seepage Trench c. ❑ See a e Pit
2. PERCOLATION RATE 3. ABSORPTION AREA 4. ABSORPTION AREA 5. SYSTEM ELEVATION 6. WATER SUPPLY:
(Minutes per inch): REQUIRED (Square Feet): PROPOSED (Square Feet):
Feet Private ❑Joint ❑ Public
VI. TANK CAPACITY
in allons Total # of Prefab. Site Fiber- Exper.
INFORMATION New xisting Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App
Tanks Tanks structed
Septic Tank or Holding Tank ✓ Li [_1 ❑ ❑ ❑
Lift Pump Tank/Si hon Chamber ❑ ❑ ❑ ❑ ❑
VII. RESPONSIBILITY STATEMENT
I, the undersigned, assume responsibility for installation of the private sewage system shown on the attached plans.
Plu erg Name (Print): Plu er's Signat re: Stamps) MP/MPRSW No.:' Business Phone Number:
lum er's Addr ss (Street ~iity, State, Zip Code):
Name of Designer:
y
VIII. SOIL TEST INFORMATION
Certi ' d So' Tester (C
T) Name CST #
113, ,
CST's DRESS( et, City, St e, Zip Code) Phone Number:
14 L~
IX. COUNTY/DEPARTMENT USE ONLY
X❑ Disapproved Sanitary Permit Fee Groundwater Date Issuing Agent Signature (No Stamps)
Approved ❑ Owner Given Initial Surcharge Fee
Adverse Determination - '00
X. COMMENTS/REASONS FOR DISAPPROVAL:
SBD-6398 (formerly Plb-67) (R. 03/86) DISTRIBUTION: Original to County, One Copy To: Bureau of Plumbing, Owner, Plumber
INFORMATION & INSTRUCTIONS FOR COMPLETING A SANITARY PERMIT '
APPLICATION
TO THE APPLICANT:
1. This sanitary permit is valid for two (2) years;
2. Your sanitary permit may be renewed before the expiration date, and at the time of renewal any new
criteria in the Wisconsin Administrative Code will be applicable;
3. All revisions to this permit must be approved by the permit issuing authority. A new permit may be needed
if there is a change in your building plans, system location, estimated wastewater flow (number of bed-
rooms, etc.), depth of system, or type of system;
4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be
submitted to the county prior to installation;
5. Private sewage systems must be properly maintained. The septic tank(s) should be pumped by a licensed
pumper whenever necessary, usually every 2 to 3 years;
6. If you have questions concerning your privat- sewage system, contact your local code administrator or the
State of Wisconsin, Bureau of Plumbing, 608-266-3815.
To be complete and accurate this sanitary permit application roust include:
1. Property owner., name and mailing address. Provide the legal description where the system is to be
installed;
II. Type of building or use served: If public is checked, indicate type of use (i.e. 10 unit apartment, 30 seat
restaurant, etc.). Fill in number of bedrooms if building is a one or two family dwelling;
III. Purpose of application: Check only one in ##1. Complete ##2 if permit is for tank replacement, reconnection or
repair;
IV. Type of system: check all appropriate boxes depending on system type. Check experimental only if project
is in conjunction with University of Wisconsin;
V. Absorption system information: Provide all information requested in ##1-6;
VI. Tank information: Fill in the capacity of every new and/or existing tank, list the total gallons to be installed,
number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete
for all septic, lift/siphon chamber and holding tanks for this system. Check experimental approval only if
tanks received experimental product approval from DILHR;
VII. Responsibility statement: Installing plumber is to fill in name, license number with appropriate prefix (e.g.
MP, etc.), address and phone number. Plumber must sign application form. Fill in designer name if
applicable;
VIII. Soil test information: Certified soil tester's name, certification number, address, and phone number.
IX. County/Department Use Only;
X. Comment area for use by county or resaon given when application is disapproved.
Complete plans and specifications not smaller than 8'/2 X 11 inches must be submitted to the county. The
plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of
holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service;
streams and lakes; dosing or pumping chambers; distribution boxes; soil absorption systems; replacement
system areas; and the location of the building served; B) horizontal and vertical elevation reference points;
C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump
performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if
required by the county; E) soil test data on a 115 form.
GROUNDWATER SURCHARGE
On May 4, 1984, 1983, Wisconsin Act 410 was signed into law. This legislation is more
commonly known as the groundwater protection law. This change in statutes was the
result of over 2 years of steady negotiation and public debate. The groundwater bill groundwater 1'
included the creation of surcharges (fees) for a number of regulated practices which wiscon~sin`s
ran effect groundwater. The surcharge took effect on July 1, 1984. All of the water tha° buried ~reasure
is used in your building is returned to the groundwater through your soil absorption
system or the disposal site used by your holding tank pumper.
Tlie monies collected through these surcharges are credited to the groundwater fund adminis-
t ree by the Department of Natural Resources. These funds are used `or monitoring ground-
water, g° lundwater contamination investigations and establishment o, standards. Groundwater, it's worth protecting.
SBD-6398 (8.03/86)
Parcel 038-1106-60-200 02/0712007 08:54 AM
PAGE 1 OF 1
Alt. Parcel 26.31.18.447B 038 - TOWN OF STAR PRAIRIE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - SIEGERT, DAVID A & GINNY
DAVID A & GINNY SIEGERT
1926 CTY RD CC
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 1926 CTY RD CC
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 5.000 Plat: 4240-CSM 15/4240
SEC 26 T31 N R1 8W NE SE LOT 2 CSM 15/4240 Block/Condo Bldg: LOT 2
i
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
26-31N-18W NE SE
Notes: Parcel History:
Date Doc # Vol/Page Type
11/19/2004 780393 2699/028 QC
02/27/2002 672139 1843/521 WD
07/23/1997 791/173
07/23/1997 749/533
2007 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 10/14/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.000 25,000 237,000 262,000 NO
UNDEVELOPED G5 4.000 22,000 0 22,000 NO
Totals for 2007:
General Property 5.000 47,000 237,000 284,000
Woodland 0.000 0 0
Totals for 2006:
General Property 5.000 47,000 237,000 284,000
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
J
APPLICATION FOR SANITARY PERMIT
STC - 100
This application form is to be completed in full and signed by the owner(s) of the
property being developed. Any inadequacies will only result in delays of the permit
issuance. Should this development be intended for resale by owner/contractor, ("spec
house"), then a second form should be retained and completed when the property is
sold and submitted to this office with the appropriate deed recording.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Owner of Property
Location of Property's Section -P 40, , T3,1 N-R_26
W
Township
Mailing Address
Address of Site
Subdivision Name
Lot Number nn
Previous Owner of Property Q61~ le i-'►_____Y__!
Total Size of Parcel > v a -C a--e er_s
Date Parcel was Created
Are all corners and lot lines identifiable? Yes No
Is this property being developed for resale (spec house) ? Yes A' No
Volume 7:::~2 and Page Number s~ as recorded with the Register of Deeds.
INCLUDE WITH THIS APPLICATION THE FOLLOWING:
A Warranty Deed which includes a Document number, volume and pa&ze number, and the
Seal of the Register of Deeds. In addition, a certified survey, if available, would be
helpful so as to avoid delays of the reviewing process. If the deed description refer-
ences to a Certified Survey Map, the Certified Survey Map shall also be required.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
PROPERTY OWNER CERTIFICATION
I (We) eexa6y that att .6tatement6 on thus bonm tune true to the beat ob my (oun)
knowtedg e; that I (we) am (ane) the owneA Gs) o6 the pno pW y des cA bed in thin
.inbonmat.ion bonm, by viAtue ob a wa&&anty d ed neconded in the Obb.ice ob the
County Reg.usten ob Veeda as Document No. y~; and that I (we) ptuentty
awn the proposed .s.cte bon the sewage dizpod zyss em (on I (we) have obtained an
ea3ement, to nun with the above de,scni.bed pxopenty, bon the cowstlructi.on ob Aa.i,d
system, and the .tame had been duty neconded in the Obb,iee ob the County Reg.usten ob
Deeda, a3 oeument No.
SIGNATURE F /ER SIGNATURE OF CO-OWNER (IF APPLICABLE)
DAT SI ED DATE SIGNED
z
CA
- y
9
STC - 105 r
r
a
SEPTIC TANK MAINTENANCE AGREEMENT ~o
St. Croix County z
d
OWNER/BUYER ROUTE/BOX NUMBER R Fire Number
CITY/STATE ZIP ,S y® / 7
PROPERTY LOCATION:N67 14, 14, Section a , TS) N, R /cS W,
Town of P , St. Croix County,
0
Subdivision , Lot number
f
Improper use and maintenance of your septic system could result in
its premature failure to handle wastes. Proper maintenance con-
sists of pumping out the septic tank every three years or sooner,
if needed, by a licensed septic tank pumper. What you put into
the system can affect the function of the septic tank as a treat-
ment stage in the waste disposal system.
St. Croix.County residents may be eligible to receive a grant for
a maximum of 60% of the cost of replacement of a failing system,
which was in operation prior to July 1, 1978. St. Croix County
accepted this program in August of 1980, with the requirement that
owners of all new systems agree to keep their systems properly
maintained.
The property owner agrees to submit to St. Croix County Zoning a
certification form, signed by the owner and by a master plumber,
journeyman plumber, restricted plumber or a licensed pumper veri-
fying that (1) the on-site wastewater disposal system is in proper
operating condition and (2) after inspection and pumping (if nec-
essary), the septic 'tank is less than 1/3 full of sludge and scum.
Certification form will be sent approximately 30 days prior to
three year expiration. H
0
C.
I/WE, the undersigned, have read the above requirements and agree N
to maintain the private sewage disposal system in accordance with x
the standards set forth, herein, as set by the Wisconsin Depart- ~d
ment of Natural Resources. Certification form must be completed
and returned to the St. Croix County Zoning Office within 30 days
of the three year expiration date.
SIGNED
DATE /
St. Croix County Zoning Office
P.O. Box 98-
Hammond, WI 54015
715-796-2239 or 715-425-8363
Sign, date and return to above address.
Jow
l {
A u
zz qGo
- /8o'
r
s
DEPARTMENT OF REPORT ON SOIL BORINGS AND SAFETY & BUILDINGS
INDUSTRY, DIVISION
LABOR AND PERCOLATION TESTS (115) MADISOP.O. BOX N WI 7969
HUMAN RELATIONS
(H63.090) & Chapter 145.045)
LOCATION: SECTION: TOWNSHIP /MUN IPALITY: LOT r4O.: O.: SUBDIVISION NAME:
N/R/ X (or) W n ltI ,w
C NTY: WNE 'S/BUYER'S NAME: MAILING ADDRESS:
l C rr--% YN,C' L $ C
USE DATES OBSERV IONS MADE
Zry NO. BEDRMS.: ICOMMERCIA DESCRIPTION: PROFILE DESCRIPTIONS: PERCOLATION TESTS:
Residence New ❑Replace ~4 ~C%
RATING: S= Site suitable for system U= Site unsuitable for system /
CONVENTIONAL: MOUND IN-GROUNDPRESSUR_E: SYSTEM-IN-FILL LDI G TANK: RECOMMENDED $YST M:(optional)
CIS ❑U CIS ❑U IMS ❑U ❑S CU ❑S ~]U /
If Percolation Tests are NOT require DATE: If any portion of the tested area is in the
under s.H63.09(5)(b), indicateFloodplain, indicate Floodplain elevation:
PROFILE DESCRIPTIONS
BORING TOTAL ELEVATION DEPTH TO GROUNDWATER-INCHES CHARACTER OF SOIL WITH THICKNESS, COLOR, TEXTURE, AND DEPTH
NUMBER DEPTHfIl1 OBSERVED EST. HIGHEST TO BEDROCK IF OBSERVED (SEE ABBRV.ON BACK.)
B- Z Xisdee,
B-
L9 7 _ -9
B-S-2 Z&s _7 :7
B S i s
B-
PERCOLATION TESTS
TEST DEPTH, WATER IN HOLE TEST TIME DROP IN WATER LEVEL-INCHES RATE MINUTES
NUMBER LW.G"ES AFTERSWELLING INTERVAL-MIN. PERIO 1 PER10 2 PERT 3 PER INCH
P- / i
P-
P-3 yg
P-_
P-
P-
-71
PLOT PLAN: Show locations of percolate n tests, soil borings and the dimensions of suitable soil areas. Indicate scale or distances. Describe what are the hori-
zontal and vertical elevation rejere • nts and show their location on the plot plan. Show the surface elevation at all borings and t direction and percent
of land slope. ` /W -
SYSTEM ELEV~TION . 2
_ I
/q{ ~j~p7,.,e yq ,
i
S
E
eo
_ ._.w.
. III
1 t
. E.
e
f
1 ( c = 1
- ! 1
r- w_
1_1 1-- J I
1, th undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures' ified in th WiV c nsin
Administrative Code, and that the data recorded and the location of the tests are correct to the best of my knowledge and belief.
NAM prin TESTS WERE COMPLETED ON:
S
A S: CERTIFICATION NUMBER: PHONE NUMBER (optional):
CS IGNATU E:
DISTRIBUTION: Original and one copy to Local Authority, Property Owner and Soil Tester.
DILHR-SBD-6395 (R. 02/82) - OVER -
14STRUICTIONS FOR I-MI TING ~M 115 - D -
TO and acnurate soil test. , I sort ")W
indicate v !5 1a - ;oCl mer .
3. M. X U om~ 7 -cial use pla it
4. Is this a nE
TE IS SUITABLE FOR AHOLDIN - ALY IF ALL
S _ a L CQNDITIr'I S;
de . i r the,
7 - locatio is. i e is prefern A
noint ar d are permanent;
laot bon test exemp-
10. If I the api box;
11. Si
1 " T_ W JT BE FILED WITH THE
R _Y l
n -a . a ~~ro FCn 8 ~ F EC C TES
1CI
*S In
oam y _
y Loam
L --m
' si, '..-Ir"
r
cc
p- rum -
n, d
i : -Jfires
VRP - Point
T THE C
~ . tent may reeit
for the i
in
i - nstructi
i
PAGE OF
CroSS See~tun O~ A Zco S stem
Fresh Air Inlets And Observation Pipe
1:=~-Approved Vent Cap
Minimum 12" Above
Final Crods
0
20- 42" Above Pipe _ 4" Cast Iron
To Final Orode Vent Pipe
Marsh Fay Or Synthetic Covering
MIn. 2" Aggregate
Over Plps
Cistrlbuti n - Tee
pipe o 0 0 0
I
~ 6" Aggregate a Perforated Pipe Below
Beneath Plpe
Covpllog Terminating At
Bottom Of system
~ PruPoSeD ~ine~) 19rc.c~{
' ~~cJe.T F on / ~
SOIL FILL
DISTKIBUYIpA.1 PIPE
APPROVED S4M{ETIC COVER
oFl16GR~~ATE.-fir c~ z MATFRI^t- OR 9" OF STRAW
OR MARSH HAy
LEV. o 4o' OF 12 -21/2 AGGREGATE
E F 44 FEET--
DISrRIt3t~TI01J PIPE TO BE AT LEAST L IMCHES BELOW ORIGIIJAL GRADE
AMU AT LEASTZO IIJCHES BUT 1.10 MORE THAI) 42 INCHES BELOW FINAL GRADE
MAXIMUM DEPTH OF EXCAVAT160 FRaM OWNAL 6RAM WILL BE IIJCHES
rdt(IMUM MrN OF EXCAVATION FRoM 04KI(INAL CGROE WILL BE INCHES
d
t
N
C f
SIGA]EO: ~ f
LICEMSE DUMBER: i/ l
DATE :,--2-- sC -.f6,
66L36,G
JUL - 8 2002
U Ch I.._- 15 F:" O l C3 E- 4240
KA T'HE*EZf ' H. WALSH
ST,CROIX000NTY REGISTER OF DEEDS
SURVEYOR'S RECORD ' T . CROIX CO. , WI
RECEIVED FOR RECORD
CERTIFIED SURVEY MAP 01-18-2002 10:00 A8
LOCATED IN THE NE1/4 OF THE SE1/4 OF COPY FEE: 4.00
RECORDING 15 AGES: FEE: 3 .00
SECTION 26, T31 N, RI 8W, TOWN OF STAR P
PRAIRIE, ST. CROIX COUNTY, WISCONSIN.
LEGEND
N ALUMINUM COUNTY SECTION PREPARED FOR
CORNER MONUMENT FOUND
JERRY AND BECKY LARSON
w~ z 1" X 24" IRON PIPE SET WEIGHING 1926 CTY RD "CC"
Z 1.13 LBS. PER LINEAR FOOT NEW RICHMOND, WI 54017
¢ * ~I
of
cr 1" IRON PIPE FOUND
LL N •
w w ~ SURVEYOR
N
- r
w N a 100' ROADWAY SETBACK EDWIN C FLANUM ~t
00
Q ~ z 03 NORTHLAND SURVEYING, INC. D o
O cggn X EXISTING FENCELINE P.0 BOX 14
z F u co ♦ SOIL BORING ROBERTS, WI 54023 0 "I Oj d
o
,
Q
~LL
O O o e o o W 41.2epl W
MGi]G? tt~CDf~]DD O~[n]CD C~3~ OO 4[~CCG3~ pbd"
- - -
W1/4 CORNER - - - I I O
SECTION 26 195TH AVENUE E1/4 CORNER
S88°41'22"W 1- SECTION 26
ft 3915.16' _ S88°41'22"W 1320.48' - 14! a
M EXISTING CENTERLINE _ EAST -WEST 1/4 LINE
PROPOSED
S88°25'42W 1270.74-
DRIVE
•.••••..••.1. c
50' 50'
L
.
l'1cd i z00z ~q 1 01
00
00
Z~
I
al
cq CD
cv LOT 1
o c
I M l S89°01'51%
r 34.67 ACRES INC. RNV ~ 8.75'
1 W 1,510,237 SQ. FT. I =
N l FIELD
r 32.32 ACRES EXC. R/W f DRIVE -
j 1,407,797 SQ. FT. 0
lx)
Oi O T IN
O I Q' LLJ CO Z
0 r
rn
N U- A CD 91 25
o
al O G
a
w ♦ S88°56'5$"W 548.62' z`Q' I Z;
0. z 507.37' 41.25' 50'
w ~
AREA OF LOT 2 SVENT
LL
h
a 5.00 ACRES INC. R/W g ® ° `s T
217,800 SQ. FT. SHED SEPTIC ti
! ? N g
~ M a CLEAN OUT `r r-
co 4.47 ACRES EXC. R/W W ® 00 M
194,645 SQ. FT. N @
11 5'
HOUSE
LOT 2 PooEA oI
LAR ~0ZI 65' 50'
I
1261.13' d 'r 548.62'
777.51' 483.62' DRIVE 65.00'
a
N88°56'55"E 1326.13' w
SOUTH LINE OF THE NE1/4 OF THE SE1/4
D[n`~l[PRAUUGD LZrADDD OMBMT) Mw @Umr ng ~9 0
- - 00 CO
- g ~~zo
SCALE IN FEET 1" = 200' z t;
~
SE CORNER
200 0 200 400 SECTION 26
THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO.01-59 DATE: 9-11-01 SHEET 1 OF 3 SHEETS ~/)1
V01.15 Page 4240 so